Wiki Foot Surgery

[janice.rose@yahoo.com]

I need some help with coding this surgery... How would you code this? I attached the record. Any help would be greatly appreciated.

 

[Orthocoderpgu]

I see a repeat Lapid procedure. The patient had a prior Lapid and removing the hardware from the previous surgery was necessary to perform this surgery, so 20680 is not billable. 28297 for the Lapid. I would say 28270 for the work done at the MTP joint. From the note it seems the patient's issue was more of a foot contracture rather than DJD in the area. After performing the capsulotomy the soft tissue was moved around to break up any adhesions or contracture to the joint and then it was sewn back up. I think I would talk to your doc about the "tendon transfer'. As documented, it seems to be just cut and put back into place after the capsulotomy is completed. It could be that the tendon was transferred to give support to the MTP joint, which I have never seen before. As documented I would not code it as a transfer since according to the documentation it was just cut and put back into place. But speak with your doc which foot/ankle coders have to do more than other ortho coders and this is a good reason why. If it was transferred, I would want the documentation to reflect that. Good luck and let me know how it goes.